Blade cooling gas/fluid storage

ABSTRACT

A surgical instrument includes a body, a shaft assembly, an end effector, a clamp actuator, and a blade cooling system. The end effector has a clamp arm and an ultrasonic blade coupled with an ultrasonic transducer. The clamp arm is configured to selectively move from a first actuator position toward a second actuator position thereby directing movement of the clamp arm from the open position toward the closed position, respectively. The cooling system is operable to deliver fluid coolant to the ultrasonic blade to thereby cool the ultrasonic blade while the clamp actuator remains in the first actuator position.

BACKGROUND

A variety of surgical instruments include an end effector having a bladeelement that vibrates at ultrasonic frequencies to cut and/or sealtissue (e.g., by denaturing proteins in tissue cells). These instrumentsinclude one or more piezoelectric elements that convert electrical powerinto ultrasonic vibrations, which are communicated along an acousticwaveguide to the blade element. The precision of cutting and coagulationmay be controlled by the operator's technique and adjusting the powerlevel, blade edge angle, tissue traction, and blade pressure.

Examples of ultrasonic surgical instruments include the HARMONIC ACE®Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONICFOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades,all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Further examplesof such devices and related concepts are disclosed in U.S. Pat. No.5,322,055, entitled “Clamp Coagulator/Cutting System for UltrasonicSurgical Instruments,” issued Jun. 21, 1994, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 5,873,873, entitled“Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,”issued Feb. 23, 1999, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,980,510, entitled “Ultrasonic ClampCoagulator Apparatus Having Improved Clamp Arm Pivot Mount,” issued Nov.9, 1999, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,283,981, entitled “Method of Balancing AsymmetricUltrasonic Surgical Blades,” issued Sep. 4, 2001, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,309,400,entitled “Curved Ultrasonic Blade having a Trapezoidal Cross Section,”issued Oct. 30, 2001, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 6,325,811, entitled “Blades withFunctional Balance Asymmetries for use with Ultrasonic SurgicalInstruments,” issued Dec. 4, 2001, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,423,082, entitled“Ultrasonic Surgical Blade with Improved Cutting and CoagulationFeatures,” issued Jul. 23, 2002, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 6,773,444, entitled “Blades withFunctional Balance Asymmetries for Use with Ultrasonic SurgicalInstruments,” issued Aug. 10, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,783,524, entitled“Robotic Surgical Tool with Ultrasound Cauterizing and CuttingInstrument,” issued Aug. 31, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,057,498, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 15, 2011, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,461,744, entitled “Rotating Transducer Mount for Ultrasonic SurgicalInstruments,” issued Jun. 11, 2013, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,591,536, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 26, 2013, thedisclosure of which is incorporated by reference herein; and U.S. Pat.No. 8,623,027, entitled “Ergonomic Surgical Instruments,” issued Jan. 7,2014, the disclosure of which is incorporated by reference herein.

Still further examples of ultrasonic surgical instruments are disclosedin U.S. Pub. No. 2006/0079874, entitled “Tissue Pad for Use with anUltrasonic Surgical Instrument,” published Apr. 13, 2006, now abandoned,the disclosure of which is incorporated by reference herein; U.S. Pub.No. 2007/0191713, entitled “Ultrasonic Device for Cutting andCoagulating,” published Aug. 16, 2007, now abandoned, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2007/0282333,entitled “Ultrasonic Waveguide and Blade,” published Dec. 6, 2007, nowabandoned, the disclosure of which is incorporated by reference herein;U.S. Pub. No. 2008/0200940, entitled “Ultrasonic Device for Cutting andCoagulating,” published Aug. 21, 2008, now abandoned, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 8,911,460,entitled “Ultrasonic Surgical Instruments,” issued Dec. 16, 2014, thedisclosure of which is incorporated by reference herein; and U.S. Pat.No. 9,023,071, entitled “Ultrasonic Device for Fingertip Control,”issued May 5, 2015, the disclosure of which is incorporated by referenceherein.

Some ultrasonic surgical instruments may include a cordless transducersuch as that disclosed in U.S. Pat. No. 9,381,058, entitled “RechargeSystem for Medical Devices,” issued Jul. 5, 2016, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0116265,entitled “Surgical Instrument with Charging Devices,” published May 10,2012, now abandoned, the disclosure of which is incorporated byreference herein; and/or U.S. Pat. App. No. 61/410,603, filed Nov. 5,2010, entitled “Energy-Based Surgical Instruments,” the disclosure ofwhich is incorporated by reference herein.

Some ultrasonic surgical instruments may include an articulating shaftsection. Examples of such ultrasonic surgical instruments are disclosedin U.S. Pat. No. 9,393,037, issued Jul. 19, 2016, entitled “SurgicalInstruments with Articulating Shafts,” the disclosure of which isincorporated by reference herein; and U.S. Pat. No. 9,095,367, issuedAug. 4, 2015, entitled “Flexible Harmonic Waveguides/Blades for SurgicalInstruments,” the disclosure of which is incorporated by referenceherein.

Additionally, some ultrasonic surgical instruments may include anultrasonic blade cooling system. Examples of such ultrasonic instrumentsare disclosed in U.S. Pub. No. 2019/0000499, entitled “Features to DriveFluid Toward an Ultrasonic Blade of a Surgical Instrument,” publishedJan. 3, 2019, issued as U.S. Pat No. 10,856,897 on Dec. 8, 2020, thedisclosure of which is incorporated by reference herein; and U.S. Pub.No. 2016/0143659, entitled “Ultrasonic Surgical Instrument with BladeCooling Through Retraction,” published May 26, 2016, issued as U.S. Pat.No. 10,433,863 on Oct. 8, 2019, the disclosure of which is incorporatedby reference herein.

While several surgical instruments and systems have been made and used,it is believed that no one prior to the inventors has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a diagrammatic view of an example of a surgical systemincluding a first exemplary ultrasonic surgical instrument;

FIG. 2 depicts a side elevational view of a second exemplary ultrasonicsurgical instrument;

FIG. 3 depicts a perspective view of an end effector and a shaftassembly of the ultrasonic surgical instrument of FIG. 2;

FIG. 4 depicts a perspective view of a third exemplary ultrasonicsurgical instrument having a handle assembly, a shaft assembly, and anend effector;

FIG. 5A depicts a cross-sectional side view of the end effector of FIG.4 taken along a centerline thereof and in a closed position forcompressing a tissue;

FIG. 5B depicts the cross-sectional side view the end effector similarto FIG. 5A, but with the end effector in an open position for receivingor releasing the tissue;

FIG. 6A depicts a side elevational view of the handle assembly of FIG. 4with a housing shroud removed for greater clarity and a fluid reservoirbeing filled with fluid by a syringe;

FIG. 6B depicts the side elevational view of the handle assembly similarto FIG. 6A, but showing the fluid reservoir filled with fluid;

FIG. 6C depicts the side elevational view of the handle assembly similarto FIG. 6B, but showing fluid being discharged from the fluid reservoir;

FIG. 7A depicts an enlarged, cross-sectional side view of a one-wayfluid valve of the shaft assembly of FIG. 4 taken along a centerline ofthe shaft assembly of FIG. 4 with the one-way fluid valve in a closedposition;

FIG. 7B depicts the enlarged, cross-sectional side view of the one-wayfluid valve of the shaft assembly similar to FIG. 7B, but showing theone-way fluid valve in an open position;

FIG. 8 depicts an enlarged, side elevational view of a fourth exemplaryultrasonic surgical instrument with a housing shroud removed for greaterclarity;

FIG. 9 depicts a flowchart representing an exemplary method for coolingan ultrasonic blade of the ultrasonic surgical instrument of FIG. 8;

FIG. 10 depicts a line graph illustrating an example data set resultingfrom the exemplary method for cooling the ultrasonic blade of FIG. 9;

FIG. 11A depicts a side elevational view of a fifth exemplary ultrasonicsurgical instrument with a housing shroud removed for greater clarityand a clamp actuator in a first position;

FIG. 11B depicts the side elevational view of the ultrasonic surgicalinstrument similar to FIG. 11A, but showing the clamp actuator in asecond position;

FIG. 11C depicts the side elevational of the ultrasonic surgicalinstrument similar to FIG. 11B, but showing the clamp actuator in athird position;

FIG. 12A depicts a side elevational view of a sixth exemplary ultrasonicsurgical instrument with a housing shroud removed and a clamp actuatorin a first position;

FIG. 12B depicts the side elevational view of the ultrasonic surgicalinstrument similar to FIG. 12A, but showing the clamp actuator in asecond position;

FIG. 13 depicts a sectional side view of a fluid reservoir of theultrasonic surgical instrument of FIG. 12A; and

FIG. 14 depicts a line graph illustrating an example data set resultingfrom an exemplary method for cooling an ultrasonic blade of theultrasonic surgical instrument of FIG. 12A.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily shown inthe drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to an operator or other operator grasping a surgicalinstrument having a distal surgical end effector. The term “proximal”refers the position of an element closer to the operator or otheroperator and the term “distal” refers to the position of an elementcloser to the surgical end effector of the surgical instrument andfurther away from the operator or other operator.

I. Overview of Exemplary Ultrasonic Surgical System

FIG. 1 shows components of an example of a surgical system (10) indiagrammatic block form. As shown, system (10) comprises an ultrasonicgenerator (12) and a first exemplary ultrasonic surgical instrument(20). As will be described in greater detail below, instrument (20) isoperable to cut tissue and seal or weld tissue (e.g., a blood vessel,etc.) substantially simultaneously, using ultrasonic vibrational energy.Generator (12) and instrument (20) are coupled together via cable (14).Cable (14) may comprise a plurality of wires; and may provideunidirectional electrical communication from generator (12) toinstrument (20) and/or bidirectional electrical communication betweengenerator (12) and instrument (20). By way of example only, cable (14)may comprise a “hot” wire for electrical power to surgical instrument(20), a ground wire, and a signal wire for transmitting signals fromsurgical instrument (20) to ultrasonic generator (12), with a shieldsurrounding the three wires. In some versions, separate “hot” wires areused for separate activation voltages (e.g., one “hot” wire for a firstactivation voltage and another “hot” wire for a second activationvoltage, or a variable voltage between the wires proportional to thepower requested, etc.). Of course, any other suitable number orconfiguration of wires may be used. It should also be understood thatsome versions of system (10) may incorporate generator (12) intoinstrument (20), such that cable (14) may simply be omitted.

By way of example only, generator (12) may comprise the GEN04, GENII, orGEN 300 sold by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Inaddition, or in the alternative, generator (12) may be constructed inaccordance with at least some of the teachings of U.S. Pat. No.8,986,302, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices,” issued Mar. 24, 2015, the disclosure of whichis incorporated by reference herein. Alternatively, any other suitablegenerator (12) may be used. As will be described in greater detailbelow, generator (12) is operable to provide power to instrument (20) toperform ultrasonic surgical procedures.

Instrument (20) comprises a handpiece (22), which is configured to begrasped in one hand (or two hands) of an operator and manipulated by onehand (or two hands) of the operator during a surgical procedure. Forinstance, in some versions, handpiece (22) may be grasped like a pencilby the operator. In some other versions, handpiece (22) may include ascissor grip that may be grasped like scissors by the operator. In someother versions, handpiece (22) may include a pistol grip that may begrasped like a pistol by the operator. Of course, handpiece (22) may beconfigured to be gripped in any other suitable fashion. Furthermore,some versions of instrument (20) may substitute handpiece (22) with abody that is coupled to a robotic surgical system that is configured tooperate instrument (20) (e.g., via remote control, etc.). In the presentexample, a blade (24) extends distally from the handpiece (22).Handpiece (22) includes an ultrasonic transducer (26) and an ultrasonicwaveguide (28), which couples ultrasonic transducer (26) with blade(24). Ultrasonic transducer (26) receives electrical power fromgenerator (12) via cable (14). By virtue of its piezoelectricproperties, ultrasonic transducer (26) is operable to convert suchelectrical power into ultrasonic vibrational energy.

Ultrasonic waveguide (28) may be flexible, semi-flexible, rigid, or haveany other suitable properties. As noted above, ultrasonic transducer(26) is integrally coupled with blade (24) via ultrasonic waveguide(28). Particularly, when ultrasonic transducer (26) is activated tovibrate at ultrasonic frequencies, such vibrations are communicatedthrough ultrasonic waveguide (28) to blade (24), such that blade (24)will also vibrate at ultrasonic frequencies. When blade (24) is in anactivated state (i.e., vibrating ultrasonically), blade (24) is operableto effectively cut through tissue and seal tissue. Ultrasonic transducer(26), ultrasonic waveguide (28), and blade (24) together thus form anacoustic assembly providing ultrasonic energy for surgical procedureswhen powered by generator (12). Handpiece (22) is configured tosubstantially isolate the operator from the vibrations of the acousticassembly formed by transducer (26), ultrasonic waveguide (28), and blade(24).

In some versions, ultrasonic waveguide (28) may amplify the mechanicalvibrations transmitted through ultrasonic waveguide (28) to blade (24).Ultrasonic waveguide (28) may further have features to control the gainof the longitudinal vibration along ultrasonic waveguide (28) and/orfeatures to tune ultrasonic waveguide (28) to the resonant frequency ofsystem (10). For instance, ultrasonic waveguide (28) may have anysuitable cross-sectional dimensions/configurations, such as asubstantially uniform cross-section, be tapered at various sections, betapered along its entire length, or have any other suitableconfiguration. Ultrasonic waveguide (28) may, for example, have a lengthsubstantially equal to an integral number of one-half system wavelengths(nλ/2). Ultrasonic waveguide (28) and blade (24) may be fabricated froma solid core shaft constructed out of a material or combination ofmaterials that propagates ultrasonic energy efficiently, such astitanium alloy (i.e., Ti-6Al-4V), aluminum alloys, sapphire, stainlesssteel, or any other acoustically compatible material or combination ofmaterials.

In the present example, the distal end of blade (24) is located at aposition corresponding to an anti-node associated with resonantultrasonic vibrations communicated through waveguide (28) (i.e., at anacoustic anti-node), in order to tune the acoustic assembly to apreferred resonant frequency f_(oo) when the acoustic assembly is notloaded by tissue. When transducer (26) is energized, the distal end ofblade (24) is configured to move longitudinally in the range of, forexample, approximately 10 to 500 microns peak-to-peak, and in someinstances in the range of about 20 to about 200 microns at apredetermined vibratory frequency f_(o) of, for example, 55.5 kHz. Whentransducer (26) of the present example is activated, these mechanicaloscillations are transmitted through waveguide (28) to reach blade (24),thereby providing oscillation of blade (24) at the resonant ultrasonicfrequency. Thus, the ultrasonic oscillation of blade (24) maysimultaneously sever the tissue and denature the proteins in adjacenttissue cells, thereby providing a coagulative effect with relativelylittle thermal spread. In some versions, an electrical current may alsobe provided through blade (24) to also cauterize the tissue.

By way of example only, ultrasonic waveguide (28) and blade (24) maycomprise components sold under product codes SNGHK and SNGCB by EthiconEndo-Surgery, Inc. of Cincinnati, Ohio. By way of further example only,ultrasonic waveguide (28) and/or blade (24) may be constructed andoperable in accordance with the teachings of U.S. Pat. No. 6,423,082,entitled “Ultrasonic Surgical Blade with Improved Cutting andCoagulation Features,” issued Jul. 23, 2002, the disclosure of which isincorporated by reference herein. As another merely illustrativeexample, ultrasonic waveguide (28) and/or blade (24) may be constructedand operable in accordance with the teachings of U.S. Pat. No.5,324,299, entitled “Ultrasonic Scalpel Blade and Methods ofApplication,” issued Jun. 28, 1994, the disclosure of which isincorporated by reference herein. Other suitable properties andconfigurations of ultrasonic waveguide (28) and blade (24) will beapparent to those of ordinary skill in the art in view of the teachingsherein.

Handpiece (22) of the present example also includes a control selector(30) and an activation switch (32), which are each in communication witha circuit board (34). By way of example only, circuit board (34) maycomprise a conventional printed circuit board, a flex circuit, arigid-flex circuit, or may have any other suitable configuration.Control selector (30) and activation switch (32) may be in communicationwith circuit board (34) via one or more wires, traces formed in acircuit board or flex circuit, and/or in any other suitable fashion.Circuit board (34) is coupled with cable (14), which is in turn coupledwith control circuitry (16) within generator (12). Activation switch(32) is operable to selectively activate power to ultrasonic transducer(26). Particularly, when switch (32) is activated, such activationprovides communication of appropriate power to ultrasonic transducer(26) via cable (14). By way of example only, activation switch (32) maybe constructed in accordance with any of the teachings of the variousreferences cited herein. Other various forms that activation switch (32)may take will be apparent to those of ordinary skill in the art in viewof the teachings herein.

In the present example, surgical system (10) is operable to provide atleast two different levels or types of ultrasonic energy (e.g.,different frequencies and/or amplitudes, etc.) at blade (24). To thatend, control selector (30) is operable to permit the operator to selecta desired level/amplitude of ultrasonic energy. By way of example only,control selector (30) may be constructed in accordance with any of theteachings of the various references cited herein. Other various formsthat control selector (30) may take will be apparent to those ofordinary skill in the art in view of the teachings herein. In someversions, when an operator makes a selection through control selector(30), the operator's selection is communicated back to control circuitry(16) of generator (12) via cable (14), and control circuitry (16)adjusts the power communicated from generator (12) accordingly the nexttime the operator actuates activation switch (32).

It should be understood that the level/amplitude of ultrasonic energyprovided at blade (24) may be a function of characteristics of theelectrical power communicated from generator (12) to instrument (20) viacable (14). Thus, control circuitry (16) of generator (12) may provideelectrical power (via cable (14)) having characteristics associated withthe ultrasonic energy level/amplitude or type selected through controlselector (30). Generator (12) may thus be operable to communicatedifferent types or degrees of electrical power to ultrasonic transducer(26), in accordance with selections made by the operator via controlselector (30). In particular, and by way of example only, generator (12)may increase the voltage and/or current of the applied signal toincrease the longitudinal amplitude of the acoustic assembly. As amerely illustrative example, generator (12) may provide selectabilitybetween a “level 1” and a “level 5,” which may correspond with a blade(24) vibrational resonance amplitude of approximately 50 microns andapproximately 90 microns, respectively. Various ways in which controlcircuitry (16) may be configured will be apparent to those of ordinaryskill in the art in view of the teachings herein. It should also beunderstood that control selector (30) and activation switch (32) may besubstituted with two or more activation switches (32). In some suchversions, one activation switch (32) is operable to activate blade (24)at one power level/type while another activation switch (32) is operableto activate blade (24) at another power level/type, etc.

In some alternative versions, control circuitry (16) is located withinhandpiece (22). For instance, in some such versions, generator (12) onlycommunicates one type of electrical power (e.g., just one voltage and/orcurrent available) to handpiece (22), and control circuitry (16) withinhandpiece (22) is operable to modify the electrical power (e.g., thevoltage of the electrical power), in accordance with selections made bythe operator via control selector (30), before the electrical powerreaches ultrasonic transducer (26). Furthermore, generator (12) may beincorporated into handpiece (22) along with all other components ofsurgical system (10). For instance, one or more batteries (not shown) orother portable sources of power may be provided in handpiece (22). Stillother suitable ways in which the components shown in FIG. 1 may berearranged or otherwise configured or modified will be apparent to thoseof ordinary skill in the art in view of the teachings herein.

II. Overview of Exemplary Ultrasonic Surgical Instrument

The following discussion relates to various exemplary components andconfigurations that may be incorporated into one or more portions ofinstrument (20), discussed briefly above. It should be understood thatthe various examples of instrument (100) described below may be readilyincorporated into surgical system (10) as described above. It shouldalso be understood that the various components and operabilities ofinstrument (20) described above may be readily incorporated into theexemplary versions of instrument (100) described below. Various suitableways in which the above and below teachings may be combined will beapparent to those of ordinary skill in the art in view of the teachingsherein. It should also be understood that the below teachings may bereadily combined with the various teachings of the references that arecited herein.

To this end, FIG. 2 illustrates a second exemplary ultrasonic surgicalinstrument (100). At least part of instrument (100) may be constructedand operable in accordance with at least some of the teachings of U.S.Pat. Nos. 5,322,055; 5,873,873; 5,980,510; 6,325,811; 6,773,444;6,783,524; 8,461,744; 8,623,027; U.S. Pub. No. 2006/0079874, nowabandoned; U.S. Pub. No. 2007/0191713, now abandoned; U.S. Pub. No.2007/0282333, now abandoned; U.S. Pub. No. 2008/0200940, now abandoned;U.S. Pat. Nos. 9,023,071; 9,381,058; U.S. Pub. No. 2012/0116265, nowabandoned; U.S. Pub. No. 2019/0000499, issued as U.S. Pat. No.10,856,897 on Dec. 8, 2020; U.S. Pub. No. 2016/0143659, issued as U.S.Pat. No. 10,433,863 on Oct. 8, 2019; U.S. Pat. Nos. 9,393,037;9,095,367; U.S. Pat. App. No. 61/410,603; and/or U.S. Pat. Nos.10,172,636. The disclosures of each of the foregoing patents,publications, and applications are incorporated by reference herein. Asdescribed therein and as will be described in greater detail below,instrument (100) is operable to cut tissue and seal or weld tissue(e.g., a blood vessel, etc.) substantially simultaneously. It shouldalso be understood that instrument (100) may have various structural andfunctional similarities with the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and/or the HARMONIC SYNERGY® Ultrasonic Blades. Furthermore, instrument(100) may have various structural and functional similarities with thedevices taught in any of the other references that are cited andincorporated by reference herein.

To the extent that there is some degree of overlap between the teachingsof the references cited herein, the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and/or the HARMONIC SYNERGY® Ultrasonic Blades, and the followingteachings relating to instrument (100), there is no intent for any ofthe description herein to be presumed as admitted prior art. Severalteachings herein will in fact go beyond the scope of the teachings ofthe references cited herein and the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and the HARMONIC SYNERGY® Ultrasonic Blades.

Instrument (100) of the present example comprises a body (122) whichincludes a handle assembly (120), a shaft assembly (130), and an endeffector (140). Handle assembly (120) further includes a pistol grip(124) and a pair of buttons (126). Additionally, handle assembly (120)can include a trigger, or clamp actuator (128), that is pivotable towardand away from pistol grip (124). It should be understood, however, thatvarious other suitable configurations may be used, including but notlimited to a pencil-grip configuration or a scissor-grip configuration.End effector (140) includes an ultrasonic blade (160) and a pivotingclamp arm (144). Clamp arm (144) is coupled with clamp actuator (128)such that clamp arm (144) is pivotable toward ultrasonic blade (160) inresponse to pivoting of clamp actuator (128) toward pistol grip (124);and such that clamp arm (144) is pivotable away from ultrasonic blade(160) in response to pivoting of clamp actuator (128) away from, such asby releasing, pistol grip (124). Various suitable ways in which clamparm (144) may be coupled with clamp actuator (128) will be apparent tothose of ordinary skill in the art in view of the teachings herein.

An ultrasonic transducer assembly (112) extends proximally from body(122) of handle assembly (120). Transducer assembly (112) is coupledwith a generator (116) via a cable (114). Transducer assembly (112)receives electrical power from generator (116) and converts that powerinto ultrasonic vibrations through piezoelectric principles. Generator(116) may include a power source and control module that is configuredto provide a power profile to transducer assembly (112) that isparticularly suited for the generation of ultrasonic vibrations throughtransducer assembly (112). By way of example only, generator (116) maycomprise a GEN 300 sold by Ethicon Endo-Surgery, Inc. of Cincinnati,Ohio. In addition, or in the alternative, generator (116) may beconstructed in accordance with at least some of the teachings of U.S.Pat. No. 8,986,302, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices,” issued Mar. 24, 2015, the disclosure of whichis incorporated by reference herein. It should also be understood thatat least some of the functionality of generator (116) may be integratedinto handle assembly (120), and that handle assembly (120) may eveninclude a battery or other on-board power source such that cable (114)is omitted. Still other suitable forms that generator (116) may take, aswell as various features and operabilities that generator (116) mayprovide, will be apparent to those of ordinary skill in the art in viewof the teachings herein.

With reference to FIG. 3, shaft assembly (130) of the present examplecomprises an outer sheath, such as outer tube (132), and an inner tube(176). Inner tube (176) is slidably disposed within outer tube (132). Aswill be discussed in more detail below, inner tube (176) is operable totranslate longitudinally within outer tube (132) relative to outer tube(132) to selectively pivot clamp arm (144) toward and away from blade(160). Shaft assembly (130) of the present example further includes arotation knob (139). Rotation knob (139) is operable to rotate theentire shaft assembly (130) and end effector (140) relative to handleassembly (120) about a longitudinal axis of shaft assembly (130). Insome versions, rotation knob (139) is operable to selectively lock theangular position of shaft assembly (130) and end effector (140) relativeto handle assembly (120) about the longitudinal axis of shaft assembly(130). For instance, rotation knob (139) may be translatable between afirst longitudinal position, in which shaft assembly (130) and endeffector (140) are rotatable relative to handle assembly (120) about thelongitudinal axis of shaft assembly (130); and a second longitudinalposition, in which shaft assembly (130) and end effector (140) are notrotatable relative to handle assembly (120) about the longitudinal axisof shaft assembly (130). Of course, shaft assembly (130) may have avariety of other components, features, and operabilities, in addition toor in lieu of any of those noted above. By way of example only, at leastpart of shaft assembly (130) may be constructed in accordance with atleast some of the teachings of U.S. Pat. No. 9,795,379, entitled“Surgical Instrument with Multi-Diameter Shaft,” issued Oct. 24, 2017,the disclosure of which is incorporated by reference herein. Othersuitable configurations for shaft assembly (130) will be apparent tothose of ordinary skill in the art in view of the teachings herein.

As best seen in FIG. 3, end effector (140) of the present examplecomprises clamp arm (144) and ultrasonic blade (160), with theultrasonic blade (160) coupled to the acoustic waveguide (184). Clamparm (144) includes a primary clamp pad (146) and a secondary clamp pad(not shown) that are secured to the underside of clamp arm (144), facingblade (160). Clamp arm (144) is pivotably secured to a distallyprojecting tongue (143) of outer tube (132) via a pin (142). Clamp arm(144) is operable to selectively pivot toward and away from blade (160)to selectively clamp tissue between clamp arm (144) and blade (160). Apair of arms (156) extend transversely from clamp arm (144) and aresecured to a distal portion (170) of inner tube (176) that extendslaterally between arms (156). Inner tube (176) is operable to translatelongitudinally within outer tube (132) relative to outer tube (132) toselectively pivot clamp arm (144) toward and away from blade (160). Inparticular, inner tube (176) is coupled with clamp actuator (128) suchthat clamp arm (144) pivots toward blade (160) in response to pivotingof clamp actuator (128) toward pistol grip (124); and such that clamparm (144) pivots away from blade (160) in response to pivoting of clampactuator (128) away from pistol grip (124). Clamp arm (144) may bebiased toward the open position, such that (at least in some instances)the operator may effectively open clamp arm (144) by releasing a grip onclamp actuator (128).

Blade (160) of the present example is operable to vibrate at ultrasonicfrequencies in order to effectively cut through and seal tissue,particularly when the tissue is being clamped between clamp pad (146)and blade (160). Blade (160) is positioned at the distal end of anacoustic drivetrain, including transducer assembly (112) and acousticwaveguide (184). Transducer assembly (112) includes a set ofpiezoelectric discs (not shown) located proximal to a horn (not shown)of rigid acoustic waveguide (184). The piezoelectric discs are operableto convert electrical power into ultrasonic vibrations, which are thentransmitted along acoustic waveguide (184) to blade (160) in accordancewith known configurations and techniques. By way of example only, thisportion of the acoustic drivetrain may be configured in accordance withvarious teachings of various references that are cited herein.

In the present example, the distal end of blade (160) is located at aposition corresponding to an anti-node associated with resonantultrasonic vibrations communicated through acoustic waveguide (184), inorder to tune the acoustic assembly to a preferred resonant frequencyf_(o) when the acoustic assembly is not loaded by tissue. Whentransducer assembly (112) is energized, the distal end of blade (160) isconfigured to move longitudinally in the range of, for example,approximately 10 to 500 microns peak-to-peak, and in some instances inthe range of about 20 to about 200 microns at a predetermined vibratoryfrequency f_(o) of, for example, 55.5 kHz. When transducer assembly(112) of the present example is activated, these mechanical oscillationsare transmitted through acoustic waveguide (184) to reach blade (160),thereby providing oscillation of blade (160) at the resonant ultrasonicfrequency. Thus, when tissue is secured between blade (160) and clamppad (146), the ultrasonic oscillation of blade (160) may simultaneouslysever the tissue and denature the proteins in adjacent tissue cells,thereby providing a coagulative effect with relatively little thermalspread. In some versions, an electrical current may also be providedthrough blade (160) and clamp arm (144) to also cauterize the tissue.While some configurations for an acoustic transmission assembly andtransducer assembly (112) have been described, still other suitableconfigurations for an acoustic transmission assembly and transducerassembly (112) will be apparent to one or ordinary skill in the art inview of the teachings herein. Similarly, other suitable configurationsfor end effector (140) will be apparent to those of ordinary skill inthe art in view of the teachings herein.

III. Exemplary Ultrasonic Surgical Instrument with Blade Cooling System

In some instances, one or more regions of instrument (20, 100) may heatup during extended operation of instrument (20, 100) in a surgicalprocedure. By way of example only, blade (24, 160), clamp arm (144),and/or other portions of instrument (20, 100) may eventually heat upover time. Such heating may be caused by friction and/or other factors.To the extent that the heat is initially generated in one particularcomponent of instrument (20, 100) (e.g., blade (24, 160) or clamp arm(144), etc.), such heat may be gradually transmitted to other portionsof instrument (20, 100). It may be desirable to reduce such heatingand/or otherwise manage such heating in order to avoid contacting tissuewith heated portions of instrument (20, 100) in accordance with one ormore preferences of the operator to improve patient outcomes. Forinstance, the operator may prefer end effector (140) to be relativelycooled when the operator uses end effector (140) to perform spreadingblunt dissections and/or simple tissue grasping, etc. It may also bedesirable to reduce heat and/or otherwise manage heat in a way that doesnot significantly increase the size or operability of instrument (20,100).

One merely exemplary way in which heat may be managed in instrument (20,100) is to use a fluid to cool blade (24, 160). For instance, a coolingfluid (e.g., liquid saline, etc.) may be applied to the proximal end ofblade (24, 160). The cooling fluid may then be communicated distallyalong the rest of the length of blade (24, 160) to thereby cool blade(24, 160). Various examples of ultrasonic surgical instruments (200,300, 400, 500) described below provide various structures and techniquesthrough which a cooling fluid may be communicated to a blade, such asblade (24, 160). One or more portions of such cooling featuresassociates with ultrasonic surgical instruments (200, 300, 400, 500),discussed below, may thus be incorporated, in whole or in part, ininstrument (20, 100) as desired. While various examples of featuresconfigured to cool blade (24, 160) will be described in greater detailbelow, other examples will be apparent to those of ordinary skill in theart according to the teachings herein.

A. Exemplary Ultrasonic Surgical Instrument with Fluid Plunger

FIGS. 4-7B illustrate a third exemplary ultrasonic surgical instrument(200) with a blade cooling system (241) that is configured to operatesubstantially similar to instrument (100) discussed above except for thedifferences discussed below. It should therefore be understood thatinstrument (200) may include the same components and operabilities asinstrument (20, 100), in addition to including the components andoperabilities described below. Instrument (200) of the present examplecomprises a body (222) with a handle assembly (220), a shaft assembly(230), and an end effector (240).

As with instrument (100) discussed above, body (222) is configured toreceive an ultrasonic transducer assembly (not shown). Handle assembly(220) of body (222) includes a pistol grip (224) and a pair of buttons(226). Handle assembly (220) also includes a trigger, or clamp actuator(228), that is pivotable toward and away from pistol grip (224). Endeffector (240) includes an ultrasonic blade (260) and a pivoting clamparm (244). Clamp arm (244) is coupled with clamp actuator (228) suchthat clamp arm (244) is pivotable toward ultrasonic blade (260) inresponse to pivoting of clamp actuator (228) from the first actuatorposition (the biased or “home” position) to the second actuator position(clamped toward pistol grip (224)); and such that clamp arm (244) ispivotable away from ultrasonic blade (260) in response to pivoting ofclamp actuator (228) away from pistol grip (224), such as by releasingclamp actuator (228) from the second actuator position back to the firstactuator position. In some embodiments, one or more resilient membersare used to bias clamp arm (244) and/or clamp actuator (228) to an openposition.

With respect to FIG. 5A, shaft assembly (230) of the present examplecomprises an outer sheath, or outer tube (232), and an inner tube (234).Inner tube (234) is slidably disposed within outer tube (232). As withshaft assembly (130) (see FIG. 3) discussed above, inner tube (234) isoperable to translate longitudinally within outer tube (232) relative toouter tube (232) to selectively pivot clamp arm (244) toward and awayfrom blade (260). End effector (240) of the present example comprisesclamp arm (244) and ultrasonic blade (260). Clamp arm (244) includes aprimary clamp pad (246) and a secondary clamp pad (248) that are securedto the underside of clamp arm (244), facing blade (260). Clamp arm (244)is pivotably secured to a distally projecting tongue (243) of outer tube(232) via a pin (not shown). Clamp arm (244) is operable to selectivelypivot toward and away from blade (260) to selectively clamp tissuebetween clamp arm (244) and blade (260).

FIGS. 5A-5B illustrate the operation of clamp arm (244) between a closedposition (FIG. 5A) and an open position (FIG. 5B). As shown in FIG. 5B,when inner tube (234) is in a distal position relative to outer tube(232), clamp arm (244) is in the open position. As shown in FIG. 5A, asinner tube (234) is moved proximally into an intermediate position,clamp arm (244) is pivoted toward blade (260) into an intermediateposition. Exemplary end effector (240) and shaft assembly (230) areconfigured to provide fluid coolant to an ultrasonic blade (260). Endeffector (240) is configured to operate substantially similar to endeffector (140) (see FIG. 3) discussed above except for the differencesdiscussed below. It should therefore be understood that end effector(240) may be readily substituted for end effector (140) (see FIG. 3).Various suitable ways in which clamp arm (244) may be coupled with outertube (232) and inner tube (234) will be apparent to those of ordinaryskill in the art in view of the teachings herein.

In one example, shaft assembly (230) further comprises a tube (216)disposed between outer tube (232) and inner tube (234). Tube (216) isfluidly coupled to a fluid reservoir (for example, fluid reservoir (262)as shown in FIGS. 7A-7C) and is operable to provide fluid coolant fromthe fluid reservoir to ultrasonic blade (260) via tube (216) as will bedescribed below in more detail. In one illustrative example, theproximal end of tube (216) may be closed by a one-way valve (218) thatpermits atmospheric air to be drawn into tube (216) yet inhibits fluidcoolant from escaping the proximal end of tube (216), such that tube(216) may serve as its own fluid reservoir. Although one-way valve (218)of the present example is shown as a duckbill valve, one-way valve (218)may have any other suitable configuration as will be apparent to thoseof ordinary skill in the art in view of the teachings herein.

In this example, inner tube (234) comprises a projection (215) extendingfrom a distal portion of inner tube (234). Tube (216) is disposed withinshaft assembly (230) adjacent to projection (215) of inner tube (234)such that projection (215) bears against an exterior surface of tube(216) and causes tube (216) to deform as projection (215) translateswith inner tube (234). While projection (215) bears into tube (216) andthereby deforms tube (216), projection (215) does not completely pinchtube (216) closed at the point where projection (215) engages tube(216). Instead, projection (215) is configured to leave a small gap(217) in the region where projection (215) engages tube. When inner tube(234) translates distally, projection (215) slides distally along tube(216), such that the deformation of inner tube (234) translatesdistally. This distal translation urges fluid coolant distally in innertube (234) and out through one-way valve (218). It should be understoodthat the fluid coolant may travel distally and out through one-way valve(218) even though there is still a small gap (217) in the region whereprojection (215) engages tube (216). This is because one-way valve (218)provides less resistance to the flow of fluid coolant than therestriction at gap (217) provides. However, once inner tube (234) isretracted back proximally, fluid coolant will eventually flow distallythrough gap (217) to fill the region of tube (216) distal to gap (217),placing tube (216) in a state for subsequent dispensation of fluidcoolant.

In an alternative example, shaft assembly (230) comprises a cavity (219)or void between the outer surface (235) of inner tube (234) and theinner surface (225) of outer tube (232). While this cavity (219) permitsinner tube (234) and outer tube (232) to move relative to one another toactuate clamp arm (244), cavity (219) can also be utilized to directfluid coolant (263) toward ultrasonic blade (260) such as by insertingfluid coolant (263) into cavity (219) at the proximal end andpressurizing it so it moves distally through shaft assembly (230) toexit at or near ultrasonic blade (260). In this configuration, tube(216) may not be required or, alternatively, may extend along someportion of shaft assembly (230) to fluidly connect with cavity (219).

FIGS. 6A-6C show interior components of handle assembly (220). Clampactuator (228) is pivotably coupled to body (222) such that clampactuator (228) is operable to pivot toward and away from pistol grip(224). Clamp actuator (228) is coupled with a yoke (290) via a linkage(229) such that rotation of clamp actuator (228) causes longitudinaltranslation of yoke (290). Yoke (290) is longitudinally translatablewithin body (222) between a proximal longitudinal position and a distallongitudinal position. Yoke (290) is supported by rails (not shown)formed in body (222), such that yoke (290) is constrained tolongitudinal movement. Because the proximal portion of clamp actuator(228) is coupled with yoke (290) via linkage (229), it should beunderstood that pivoting of clamp actuator (228) toward pistol grip(224) will cause proximal longitudinal translation of yoke (290) withinbody (222); and that pivoting of clamp actuator (228) away from pistolgrip (224) will cause distal longitudinal translation of yoke (290)within body (222). More particularly, pivoting of clamp actuator (228)away from pistol grip (224) causes distal longitudinal translation ofyoke (290) within body (222) which in turn causes distal translation ofinner tube (234), which in turn causes clamp arm (244) to pivot awayfrom blade (260).

As discussed above, shaft assembly (230) comprises outer tube (232) andinner tube (234) (see FIG. 5A). Shaft assembly (230) of the presentexample further includes a rotation knob (231). Rotation knob (231) isoperable to rotate an entirety of shaft assembly (230) and end effector(240) relative to handle assembly (220) about a longitudinal axis (261)defined by shaft assembly (230). By way of example only, rotation knob(231) and the associated components and features may be configured andoperable in accordance with at least some of the teachings of U.S. Pat.No. 10,206,705, entitled “Features for Communication of Fluid throughShaft Assembly of Ultrasonic Surgical Instrument,” issued Feb. 19, 2019,the disclosure of which is incorporated by reference herein.

Rotation knob (231) of shaft assembly (230) comprises a rotatablehousing (236) that is rotatably disposed about outer tube (232). In oneexample, rotation knob (231) defines a hollow interior which may befilled with fluid coolant (263) and thereby can function as a fluidreservoir (262) for fluid coolant (263). Fluid reservoir (262) isconfigured to be filled with fluid coolant and to selectively retain thefluid coolant therein. Rotation knob (231) is fluidly coupled with outertube (232) via an opening (264) defining a fluid passageway betweenfluid reservoir (262) and the fluid flow path toward ultrasonic blade(260), such as the space between inner tube (234) and outer tube (232)and/or a tube similar to tube (216) (see FIG. 5A). It should thereforebe understood that tube (216) (see FIG. 5A) may be shortened or evenomitted, such that tube (216) (see FIG. 5A) need not extend along theentire length of shaft assembly (230).

To discharge fluid coolant (263) from fluid reservoir (262) and alongshaft assembly (230), rotation knob (231) further includes a pump, suchas a plunger (270). Plunger (270) includes an arm (272) coupled to afluid actuator (274) selectively operable by operator. In at least oneexample, as shown in FIGS. 6A-6C, fluid actuator (274) is a slidablepush-tab located on handle assembly (220). Fluid actuator (274) isoperatively coupled to plunger (270) and permits operator to slidepush-tab (274) distally toward shaft assembly (230) to move plunger(270) distally away from body (222) within rotation knob (231) therebydischarging fluid coolant (263) out of rotation knob (231) via opening(264) and distally within shaft assembly (230). Opening (264) in oneexample includes a flexible seal member (not shown) operable as aone-way valve (not shown) to permit fluid coolant (263) to pass throughopening (264) once adequate pressure builds within in fluid reservoir(262) as plunger (270) moves distally through fluid reservoir (262).Flexible seal member (not shown) is conversely operable to seal opening(264) if fluid coolant (263) is not discharging into shaft assembly(230) and inhibits fluid coolant (263) from flowing back into fluidreservoir (262) from shaft assembly (230).

As shown in FIG. 6A, to fill fluid reservoir (262) with fluid coolant(263), rotation knob (231) includes an access port (266) which permitsoperator to insert fluid coolant (263) into fluid reservoir (262). Onemethod of inserting fluid coolant (263) is by use of a syringe (268). Inone example, fluid reservoir (262) may comprise a septum (not shown) onits exterior which provides access through access port (266) andprovides fluid access to an interior of fluid reservoir (262). A syringe(268) filled with fluid coolant (263) pierces through septum (not shown)such that fluid coolant (263) may be inserted into fluid reservoir (262)by discharging fluid coolant (263) from syringe (268). Alternatively,any other suitable access port and/or fluid coolant insertion mechanismmay be utilized to fill fluid reservoir (262) with fluid coolant (263).

As described above, plunger (270) is operable to force fluid coolant(263) out of fluid reservoir (262) via opening (264) and toward endeffector (240) (see FIG. 5A). In a fluid discharging motion, plunger(270) is moved distally within fluid reservoir (262) to apply pressureand thereby discharge fluid coolant (263). In a plunger return motion,such as for re-refilling fluid reservoir (262), a replacement mediumsuch as air will replace the discharged fluid coolant (263) within fluidreservoir (262). To permit air to flow into fluid reservoir (262) asplunger (270) is moved proximally away from end effector (240) (see FIG.5A), access port (266) acts as a vent to allow air to pass through andinto fluid reservoir (262) as a vacuum is created by the movement ofplunger (270). In some alternative examples, access port (266) can belocated at or near distal end (276) of rotation knob (231), therebypermitting air to refill from distal end (276) of fluid reservoir (262)as plunger (270) moves in the proximal direction.

FIG. 6B depicts fluid reservoir (262) of instrument (200) filled withfluid coolant (263). As discussed above, rotation knob (231) is capableof rotating about longitudinal axis (261) thereby rotating shaftassembly (230) and end effector (240) (see FIG. 5A) concurrently. Thisrotation capability remains operable before fluid reservoir (262) isfilled with fluid coolant (263), while it is filled with fluid coolant(263), and/or during discharge of fluid coolant (263) therefrom. Itshould be understood that rotation knob (231) may be increased in sizeto thereby increase the size and fluid capacity of fluid reservoir(262).

FIG. 6C depicts plunger (270) being moved distally within fluidreservoir (262) of instrument (200) to discharge fluid coolant (263)toward ultrasonic blade (260) (see FIG. 5A). Specifically, pressurizedfluid coolant (263) is driven through opening (264) to thereby providefluid coolant (263) to ultrasonic blade (260) before, during, or afterultrasonic blade (260) (see FIG. 5A) is operated to clamp tissue inconjunction with clamp arm (244). Operator may selectively move plunger(270) thereby discharging fluid coolant (263) at any time by actuatingfluid actuator (274). In the example shown, the operator may moveslidable tab (274) distally to affect the discharge. Operation of fluidactuator (274) and blade cooling may be performed concurrent tooperation of clamp arm (244) via clamp actuator (228) or independentlyand without necessitating operation of clamp actuator (228). Becauseblade cooling may be accomplished at any time without requiringactuation of clamp actuator (228), greater flexibility is provided tothe operator regarding blade cooling. For example, the operator mayprefer to withhold blade cooling at a particular instance after urgingclamp actuator (228), the operator may prefer blade cooling at irregularintervals, or the operator may prefer to do so in lesser or greateramounts depending on the unique circumstances of any particularprocedure.

As described in an example above, fluid coolant (263) is discharged outof fluid reservoir (262) via opening (264) and is configured to traveldistally within cavity (219) (see FIG. 5A) of shaft assembly (230). Inthis example, the operator may opt to “prime” blade cooling system (241)by moving plunger (270) distally to a predisposed placement to dischargefluid coolant (263) into cavity (219) and therefore prepare instrument(200) for quicker blade cooling during use. As such, cavity (219) (seeFIG. 5A) may include a one-way seal positioned at or near the distal endof shaft assembly (230) which is operative to inhibit fluid coolant(263) from unintentionally leaking from cavity (219) (see FIG. 5A) whileinstrument (200) is in use and is operative to selectively allow fluidcoolant (263) to exit cavity (219) (see FIG. 5A) toward ultrasonic blade(260) (see FIG. 5A).

FIGS. 7A-7B shows a one-way valve, such as an exemplary wiper seal(221), positioned within cavity (219) to selectively permit fluidcoolant (263) to discharge toward ultrasonic blade (260) (see FIG. 5A).Outer edge (223) of wiper seal (221) fixedly attaches to inner surface(225) of outer tube (232) while inner edge (227) of wiper seal (221)creates a detachable fluid seal with outer surface (235) of inner tube(234) thereby selectively blocking or permitting cooling fluid (263) topass wiper seal (221) as fluid pressure is applied by plunger (270) (seeFIG. 6A). FIG. 7A shows wiper seal (221) in a first configurationsealing fluid coolant (263) within cavity (219). FIG. 7B shows wiperseal (221) in a second configuration allowing fluid coolant (263) topass by wiper seal (221). In the first configuration of FIG. 7A, inneredge (227) of wiper seal (221) extends proximally within cavity (219) ofshaft assembly (230) and contacts inner tube (234) to create the fluidseal. In the second configuration, inner edge (227) of wiper seal (221)inverts due to the fluid pressure and extends distally within cavity(219) of shaft assembly (230). While in the second configuration, wiperseal (221) may be induced to create a gap (233) for fluid coolant (263)to pass through for cooling.

In a first example, to affect the transition of wiper seal (221) fromthe first configuration to the second configuration, distal movement ofplunger (270) within fluid reservoir (262) pressurizes fluid coolant(263) within cavity (219) to overcome the strength of the fluid seal andforce wiper seal (221) into the second configuration and to releasefluid coolant (263). In a second example, wiper seal (221) remainsbiased in the first configuration (shown in FIG. 7A) due to pressureinduced within cavity (219) while clamp arm (244) is in a closed(clamped) position, and wiper seal (221) transitions to the secondconfiguration (shown in FIG. 7B) upon releasing of clamp actuator (228)to return clamp arm (244) back to its home position. Thereafter,selective activation of fluid actuator (274) by the operator releasesfluid coolant (263) through gap (233) created in the fluid seal. In thissecond example, fluid coolant (263) is inhibited from being dischargedtoward ultrasonic blade (260) (see FIG. 5A) while a tissue clampingoperation is being performed, but permitted while clamp arm (244) (seeFIG. 5A) is released to its home (unclamped) position.

B. Exemplary Ultrasonic Surgical Instrument with Automated CoolingDelivery

FIG. 8 illustrates a fourth exemplary ultrasonic surgical instrument(300) with a blade cooling system (341) that is configured to operatesubstantially similar to instruments (100, 200) discussed above exceptfor the differences discussed below. It should therefore be understoodthat instrument (300) may include the same components and operabilitiesas instruments (100, 200), in addition to including the components andoperabilities described below. Instrument (300) of the present examplecomprises a body (322), a shaft assembly (330), and end effector (240)(see FIG. 5A). As with instruments (100, 200) discussed above, body(322) is configured to receive an ultrasonic transducer assembly (notshown). Body (322) also includes a handle assembly (320) having a pistolgrip (324) and a pair of buttons (326). Handle assembly (320) includes aclamp actuator (328) that is pivotable toward and away from pistol grip(324). Similar to instruments (100, 200), instrument (300) includes endeffector (240) (see FIG. 5A) having ultrasonic blade (260) (see FIG. 5A)and pivoting clamp arm (244) (see FIG. 5A). Clamp arm (244) (see FIG.5A) is coupled with clamp actuator (328) such that clamp arm (244) (seeFIG. 5A) is pivotable toward ultrasonic blade (260) (see FIG. 5A) inresponse to pivoting of clamp actuator (328) toward pistol grip (324);and such that clamp arm (244) (see FIG. 5A) is pivotable away fromultrasonic blade (260) (see FIG. 5A) in response to pivoting of clampactuator (328) away from pistol grip (324).

Shaft assembly (330) of the present example comprises an outer sheath,or outer tube (332), and inner tube (234) (see FIG. 5A). Inner tube(234) (see FIG. 5A) of this example is slidably disposed within outertube (332) such that inner tube (234) (see FIG. 5A) translateslongitudinally within outer tube (332) relative to outer tube (332) toselectively pivot clamp arm (244) (see FIG. 5A) toward and away fromultrasonic blade (260) (see FIG. 5A). In addition, at least one of body(322) or shaft assembly (330) includes a rotation knob (331) configuredto provide fluid communication similar to rotation knob (231) (see FIG.6A) described above; however, rotation knob (331) is not equipped withfluid reservoir (262) (see FIG. 6A) in the present example. Rather, atleast one of body (322) or shaft assembly (330) includes variouscomponents of blade cooling system (341) which addresses similar issuesas instrument (200) with regard to satisfying the desire to selectivelycool ultrasonic blade (260) (see FIG. 5A).

Blade cooling system (341) of this example includes a pump, such as asyringe (340), which is filled with a fluid coolant (363) andselectively delivered to shaft assembly (330) by a tube (342) routedthrough rotation knob (331). Similar to instrument (200), shaft assembly(330) includes cavity (219) (see FIG. 7A), which is between outer tube(332) and inner tube (234) (see FIG. 7A) and operable to transmit fluidcoolant (363) to ultrasonic blade (260) (see FIG. 5A). Alternatively,tubing may be positioned through shaft assembly (330) between outer tube(332) and inner tube (234) (see FIG. 7A) to directly deliver fluidcoolant (363) from blade cooling system (341) to ultrasonic blade (260)(see FIG. 5A). Blade cooling system (341) further includes an actuator(344), such as a linear solenoid actuator, which is electricallyconnected to a device circuit (not shown) by electrical wiring (346).The device circuit (not shown) may be, for example, similar in structureand/or function to circuit board (34) (see FIG. 1) of instrument (10)(see FIG. 1). Actuator (344) is configured to receive commands from thedevice circuit (not shown) to automatically control release of fluidcoolant (363) through tube (342) and toward ultrasonic blade (260) (seeFIG. 5A), as needed as determined by the control system. It should beunderstood that similar devices and mechanisms, such as alternativepumps, could be utilized in place of syringe (340) for discharging fluidcoolant (363).

Exemplary blade cooling system (341) of instrument (300) automates bladecooling so the operator does not have to selectively actuate the bladecooling during operation of instrument (300). Although operators may beable to discern when ultrasonic blade (260) (see FIG. 5A) requirescooling, it may be difficult in some instances for the operator to knowexactly how hot ultrasonic blade (260) (see FIG. 5A) is after heatedbeyond certain temperatures. This may be especially difficultconsidering blade temperature may increase exponentially as it comesinto contact with clamp arm (244) (see FIG. 5A). By providing automatedblade cooling delivery, instrument (300) may thus inhibit potentialblade heat-related issues which may arise when operators have controlover blade cooling system (341). In one example, automated blade coolingmay inhibit the operator from unnecessarily over-cooling ultrasonicblade (260) (see FIG. 5A) which can result in slower transections, etc.In an alternative example, under-cooling the ultrasonic blade can resultin burn-through of padding on clamp arm (244) (see FIG. 5A) or damage tosurrounding tissue.

Automated ultrasonic blade cooling is operable based on a measurement ofblade frequency, wherein the control variable is a fluid coolant (363)drip rate or any other measurable method of cooling fluid delivery. Assuch, as shown in FIG. 8, syringe (340) can be stored in body (322) andactuated based on sensed increases in temperature of ultrasonic blade(260) (see FIG. 5A). In one example, actuator (344) is also positionedin body (322) and coupled to syringe (340) and device circuit (notshown) and selectively controlled by a proportional-integral-derivativecontroller (“PID”) to inhibit fluid coolant (363) delivery while clampactuator (328) and clamp arm (244) (see FIG. 5A) are making contact, forexample, using impedance spectroscopy. In another example, blade coolingsystem (341) allows fluid coolant (363) delivery to ultrasonic blade(260) (see FIG. 5A) while clamp arm (244) (see FIG. 5A) is an in open(non-actuated) position and disallows fluid coolant (363) delivery whileclamp arm (see FIG. 5A) is in the closed (actuated) position. In stillanother example, blade cooling system (341) initiates fluid coolant(363) discharge to ultrasonic blade (260) (see FIG. 5A) when desired dueto particular blade-temperature conditions, as will be described below.

FIG. 9 shows a flowchart representing an exemplary method (348) and/orcontrol logic for cooling ultrasonic blade (260) (see FIG. 5A) ofinstrument (300) (see FIG. 8). Such control logic of the present exampleis performed on a control module (not shown) having a microprocessor(not shown) and a memory (not shown). At step (350), the control module(not shown) begins the exemplary routine which develops thefrequency-temperature behavior for a given blade-transducer pair,wherein temperature is a function of the frequency: temp=F(frequency).At step (352), control module (not shown) determines the temperaturethreshold above which cooling is desired. At step (354), the controlmodule (not shown) calculates the corresponding frequency threshold,referred to herein as the “target frequency.” At step (356), controlmodule (not shown) monitors the frequency throughout activation ofultrasonic blade (260) (see FIG. 5A). At step (358), control module (notshown) determines whether the target frequency has been reached. If thetarget frequency has not been reached, control module (not shown)returns to step (356). If the target frequency has been reached, controlmodule (not shown) moves to step (360) and initiates PID control of thefrequency using the fluid coolant (363) drip rate as a control variablein the function: U(t)=K*e(t)+K_(I)∫^(τ)e(τ)de+k_(D) (de(t)/dt), whereine=(frequency−target frequency). Next, at step (362), control module (notshown) ends PID control once the frequency has been crossed, thusindicating ultrasonic blade (260) (see FIG. 5A) has been adequatelycooled and the control system may end, at step (364), if the operationhas ended or may otherwise continuously return to step (356) and repeatthe methods described herein.

FIG. 10 shows an illustrative example of an exemplary control logicmethod (348) of FIG. 9. Once a target frequency (370) has beendetermined, the control module (not shown) will continuously monitor thefrequency of ultrasonic blade (260) (see FIG. 5A) during operation todetermine whether the target frequency has been reached, which isreflected by a decreasing frequency portion (372) wherein the frequencyis continually decreased to approach target frequency (370). Once thetarget frequency is crossed, at frequency (374), the control module (notshown) determines that the target frequency has been crossed and therebyinitiates PID control of the frequency at frequency (376), correspondingto step (360) of method (348). Once the frequency threshold has againbeen crossed at frequency (378), control module (not shown) ends PIDcontrol and ultrasonic blade frequency (380) may continue un-controlleduntil the control module (not shown) re-evaluates and initiates PIDcontrol.

C. Exemplary Ultrasonic Surgical Instrument with Diaphragm Pump

FIGS. 11A-11C illustrate a fifth exemplary ultrasonic surgicalinstrument (400) with a blade cooling system (441) configured to operatesubstantially similar to instruments (100, 200, 300) discussed aboveexcept for the differences discussed below. It should therefore beunderstood that instrument (400) may include the same components andoperabilities as instrument (100, 200, 300), in addition to includingthe components and operabilities described below. Instrument (400) ofthe present example comprises a body (422), a shaft assembly (430), andend effector (240) (see FIG. 5A). As with instruments (100, 200, 300)discussed above, body (422) is configured to receive an ultrasonictransducer assembly (not shown). Body (422) also includes a handleassembly (420) having a pistol grip (424) and a pair of buttons (426).Handle assembly (420) includes a clamp actuator (428) that is pivotabletoward and away from pistol grip (424). Similar to instruments (100,200, 300), instrument (400) includes end effector (240) (see FIG. 5A)having ultrasonic blade (260) (see FIG. 5A) and pivoting clamp arm (244)(see FIG. 5A). Clamp arm (244) (see FIG. 5A) is coupled with clampactuator (428) such that clamp arm (244) (see FIG. 5A) is pivotabletoward ultrasonic blade (260) (see FIG. 5A) in response to pivoting ofclamp actuator (428) toward pistol grip (424); and such that clamp arm(244) (see FIG. 5A) is pivotable away from ultrasonic blade (260) (seeFIG. 5A) in response to pivoting of clamp actuator (428) away frompistol grip (424).

Shaft assembly (430) of the present example comprises an outer sheath,or outer tube (432), and inner tube (234) (see FIG. 5A). Inner tube(234) (see FIG. 5A) of this example is slidably disposed within outertube (432) such that the inner tube (234) (see FIG. 5A) translateslongitudinally within outer tube (432) relative to outer tube (432) toselectively pivot clamp arm (244) (see FIG. 5A) toward and away fromultrasonic blade (260) (see FIG. 5A). In addition, at least one of body(422) or shaft assembly (430) includes a rotation knob (431) configuredto provide fluid communication similar to rotation knob (231) (see FIG.6A) described above; however, rotation knob (431) is not equipped withfluid reservoir (262) (see FIG. 6A). Rather, at least one of body (422)or shaft assembly (430) includes multiple components of blade coolingsystem (441) which addresses similar issues as instrument (200) withregard to satisfying the desire to selectively cool the ultrasonicblade.

Blade cooling system (441) of instrument (400) includes a fluidreservoir (440) configured to store fluid coolant (463). Fluid reservoir(440) is positioned within body (422) and is accessible for insertingfluid coolant (463) by an access port (442). Alternatively, fluidreservoir (440) may be coupled with body (422) or otherwise positionedwithin handle assembly (420) in any suitable manner as would be apparentto one of ordinary skill in the art. One method of inserting fluidcoolant (463) is by use of a syringe, such as syringe (268) (see FIG.6A). In one example, fluid reservoir (440) has a septum (not shown) onits exterior which provides access through access port (442) andprovides fluid access to the interior of fluid reservoir (440). Syringe(268) (see FIG. 6A) filled with fluid coolant (463) pierces through theseptum (not shown) such that fluid coolant (463) is inserted into fluidreservoir (440) by discharging fluid coolant (463) from syringe (268)(see FIG. 6A). Alternatively, any other suitable access port and/orfluid coolant insertion mechanism may be utilized to fill fluidreservoir (440) with fluid coolant (463).

Blade cooling system (441) of instrument (400) further includes a pumphaving a flexible diaphragm, such as a fluid bladder (444), in fluidconnection with fluid reservoir (440) via tube (446). Tube (446) permitsfluid coolant (463) to fill fluid bladder (444) and remain in fluidbladder (444) until actuated by operator. To inhibit fluid coolant (463)from returning to fluid reservoir (440), tube (446) includes a one-wayfluid valve (448). Once fluid coolant (463) is moved into fluid bladder(444), fluid coolant (463) remains in fluid bladder (444) until fluidbladder (444) is compressed by protruding arm (449) of clamp actuator(428) thereby forcing fluid coolant (463) through a second tube (450)toward ultrasonic blade (260) (see FIG. 5A). More particularly, fluidcoolant (463) is selectively delivered to shaft assembly (430) by tube(450) which is routed through rotation knob (431) and fluidly connectsto shaft assembly (430). Similar to instrument (200), shaft assembly(430) includes cavity (219) (see FIG. 7A), which is between outer tube(432) and inner tube (234) (see FIG. 7A) and operable to transmit fluidcoolant (463) to ultrasonic blade (260) (see FIG. 5A). Alternatively,tubing can be positioned through shaft assembly (430) between outer tube(432) and inner tube (234) (see FIG. 7A) to directly deliver fluidcoolant (463) from blade cooling system (441) to ultrasonic blade (260)(see FIG. 5A). Similar to one-way fluid valve (448) of tube (446), tube(450) also includes a one-way fluid valve (452) to inhibit fluid coolant(463) from returning to fluid bladder (444).

Instrument (400) provides operator with the ability to initiateultrasonic blade cooling at any point during operation of instrument(400) by extending clamp actuator (428) distally away from body (422)such that a pin (454) overcomes a detent (456) to permit clamp actuator(428) to extend away from body (422). In one example, pin (454) islocated on clamp actuator (428) while detent (456) is located on body(422). In an alternative example, pin (454) is located on body (422)while detent (456) is located on clamp actuator (428). This detentlocking mechanism provides a guard against unwanted forward extension ofclamp actuator (428) and therefore unwanted ultrasonic blade cooling.

By extending clamp actuator (428) distally away from body (422),protruding arm (449) compresses fluid bladder (444) and thereby pumpsfluid coolant (463) toward ultrasonic blade (260) (see FIG. 5A). Toinitiate use of instrument (400), the operator may fill fluid reservoir(440) with fluid coolant (463) as described above, and then “prime”blade cooling system (441) by extending clamp actuator (428) distallyaway from body (422) to compress fluid bladder (444) until fluid coolant(463) exits near ultrasonic blade (260) (see FIG. 5A). At this point,instrument (400) is prepared for operation as tube (450) and shaftassembly (430) are filled with fluid coolant (463). During operation,any time the operator wishes to initiate ultrasonic blade cooling, theoperator can extend clamp actuator (428) forward to discharge fluidcoolant (463).

With respect to FIG. 11A, clamp actuator (428) of instrument (400) is ina resting/home position. In this configuration, clamp arm (244) (seeFIG. 5A) of end effector (240) (see FIG. 5A) remains in an open(non-pivoted) state with regard to ultrasonic blade (240) (see FIG. 5A),and fluid bladder (444) remains in an uncompressed state therebyinhibiting fluid coolant (463) discharge through tube (450), towardshaft assembly (430), and, ultimately, ultrasonic blade (240) (see FIG.5A) for cooling.

FIG. 11B shows instrument (400) with clamp actuator (428) in an actuated(clamped) position. In this configuration, clamp arm (244) (see FIG. 5A)of end effector (240) (see FIG. 5A) is pivoted closed toward ultrasonicblade (240) (see FIG. 5A) to clamp tissue, and fluid bladder (444) stillremains in an uncompressed state thereby inhibiting fluid coolant (463)discharge through tube (450), toward shaft assembly (430), and,ultimately, to ultrasonic blade (240) (see FIG. 5A) for cooling.

FIG. 11C shows instrument (400) with clamp actuator (428) in a distallyextended position. In this configuration, clamp arm (244) (see FIG. 5A)of end effector (240) (see FIG. 5A) remains in an open (non-pivoted)state with regard to ultrasonic blade (240) (see FIG. 5A), pin (454) hasovercome and moved beyond detent (456), and fluid bladder (444) is in acompressed state. During such compression, fluid bladder (444) directsfluid coolant (463) through tube (450), toward shaft assembly (430),and, ultimately, to ultrasonic blade (240) (see FIG. 5A) for cooling. Assuch, ultrasonic blade cooling may be achieved at any time irrespectiveof operation of clamp arm (244) (see FIG. 5A).

D. Exemplary Ultrasonic Surgical Instrument with Spring LoadedPressurized Syringe

FIGS. 12A, 12B, and 13 illustrate a sixth exemplary ultrasonic surgicalinstrument (500) with a blade cooling system (541) configured to operatesubstantially similar to instruments (100, 200, 300, 400) discussedabove except for the differences discussed below. It should therefore beunderstood that instrument (500) may include the same components andoperabilities as instrument (100, 200, 300, 400), in addition toincluding the components and operabilities described below. Instrument(500) of the present example comprises a body (522), a shaft assembly(530), and end effector (240) (see FIG. 5A). As with instruments (100,200, 300, 400) discussed above, body (522) is configured to receive anultrasonic transducer assembly (not shown). Body (522) also includes ahandle assembly (520) having a pistol grip (524) and a pair of buttons(526). Handle assembly (520) includes a clamp actuator (528) that ispivotable toward and away from pistol grip (524). Similar to instruments(100, 200, 300, 400), instrument (500) includes end effector (240) (seeFIG. 5A) having ultrasonic blade (260) (see FIG. 5A) and a pivotingclamp arm (244) (see FIG. 5A). Clamp arm (244) (see FIG. 5A) is coupledwith clamp actuator (528) such that clamp arm (244) (see FIG. 5A) ispivotable toward ultrasonic blade (260) (see FIG. 5A) in response topivoting of clamp actuator (528) toward pistol grip (524); and such thatclamp arm (244) (see FIG. 5A) is pivotable away from ultrasonic blade(260) (see FIG. 5A) in response to pivoting of clamp actuator (528) awayfrom pistol grip (524).

Shaft assembly (530) of the present example comprises an outer sheath,or outer tube (532), and inner tube (234) (see FIG. 5A). Inner tube(234) (see FIG. 5A) of this example is slidably disposed within outertube (532) such that inner tube (234) (see FIG. 5A) translateslongitudinally within outer tube (532) relative to outer tube (532) toselectively pivot clamp arm (244) (see FIG. 5A) toward and away fromultrasonic blade (260) (see FIG. 5A). In addition, at least one of body(522) or shaft assembly (530) includes a rotation knob (531) operable torotate shaft assembly (530) about its longitudinal axis, similar toinstrument (200). Either one or both of body (522) or shaft assembly(530) includes various components of blade cooling system (541) whichaddresses similar issues as instrument (200) with regard to satisfyingthe desire to selectively cool ultrasonic blade (260) (see FIG. 5A).

Blade cooling system (541) of instrument (500) includes a syringe (542)housing fluid coolant (563), a pump, such as a plunger (544), a threadedplug (546), a valve (548), such as a spring-loaded valve, a deliveryline (550), and a catch trigger (552) with a detent feature (554) toactivate valve (548). In one example, valve (548) is spring-loaded viacoupling to torsion spring (549), which is positioned within and coupledto body (522). Blade cooling system (541) is installed within body (522)such that syringe (542) is pre-filled with liquid coolant (563) andinserted into a position that syringe (542) fluidly couples with valve(548) and delivery line (550). Delivery line (550) is routed to shaftassembly (530) to permit ultrasonic blade cooling. For example, byrouting through rotation knob (531), delivery line (550) dischargesfluid coolant directly into cavity (219) (see FIG. 7A) between innertube (234) (see FIG. 7A) and outer tube (532) for delivery to ultrasonicblade (260) (see FIG. 5A) similar to instrument (200). In an alternativeexample, delivery line (550) can routed though cavity (219) (see FIG.7A) between inner tube (234) (see FIG. 7A) and outer tube (532) similarto instrument (200) discussed above.

Syringe (542) includes fluid coolant (563), air, or a combination offluid coolant (563) and air in fluid reservoir (543). Fluid reservoir(543) of syringe (542) is configured to store, and be capable ofdischarging for blade cooling, approximately 120 drops (or about 6milliliters) of fluid coolant (563), such as a liquid variant of fluidcoolant (563), for each actuation cycle (rotation) of valve (548). Inone example, between approximately 3 drops and approximately 5 drops,such as approximately 4 drops of fluid coolant (563), are dischargedonto ultrasonic blade (260) (see FIG. 5A) per actuation, although itwill be appreciated that any desired amount of fluid coolant (563) forcooling may be so used with any such instrument, such as those discussedherein. After use, syringe (542) may be sterilized, refilled with fluidcoolant (563), and reused in later operations utilizing instrument(500).

Force is applied to syringe (542) to thereby discharge fluid coolant(563) into delivery line (550) upon rotation of valve (548). In thepresent example, plunger (544) of syringe (548) is configured to receiveconstant force to pressurize fluid reservoir (543) by threaded plug(546) being threaded into guide tube (556) to press against firstbearing plate (558). First bearing plate (558) contacts compressionspring (560), which maintains air compression against a second bearingplate (562), wherein second bearing plate (562) applies the constantpressure to plunger (544) for increasing fluid pressure within fluidreservoir (543). Guide tube (556) is fixedly grounded to body (522) tosupport movement and pressurization of other components of blade coolingsystem (541).

Threaded plug further includes a key (564), for example, an Allen wrenchkey, which permits operator to increase or decrease the force applied bycompression spring (560) on plunger (560) within fluid reservoir (543).More particularly, threaded plug (546) is threaded into guide tube (556)during initial setup prior to operation of instrument (500) such thatthe initial spring (560) compression raises the fluid pressure withinfluid reservoir (543) of syringe (542) to discharge fluid coolant (563)once valve (548) is actuated. During operation of instrument (500),catch trigger (552) and detent feature (554) interact each time clampactuator (528) pivots toward body (522) to rotate valve (548) and, inturn, permit fluid coolant (563) to discharge into delivery line (550).In one example, catch trigger (552) is coupled to clamp actuator (528)and detent feature (554) is coupled to valve (548). In an alternativeexample, catch trigger (552) may be coupled to valve (548) and detentfeature (554) may be coupled to clamp actuator (548).

As shown in FIG. 12A, clamp actuator (528) is squeezed such that catchtrigger (552) and detent feature (554) are not in contact and valve(542) remains unrotated. Once clamp actuator (528) is released frombeing squeezed and returned to its home position, as shown in FIGS.12B-13, catch trigger (552) momentarily contacts detent feature (554) torotate valve (548). During this momentary rotation of valve (548), afluid channel (not shown) defined within valve (548) fluidly connects topressurized fluid reservoir (543) and fluid coolant (563) dischargesinto delivery line (550) until catch trigger (552) and detent feature(554) release and torsion spring (549) moves valve (548) back to itsbiased, fluidly closed, position.

FIG. 14 shows a graphical representation of fluid coolant (563)discharge flow as result of actuation of clamp actuator position (528).As described above and shown in FIG. 12A, fluid coolant (563) does notflow (580) during a first period (570) while clamp actuator (528) is inthe process of being actuated/clamped to direct clamp arm (244) (seeFIG. 5A) to clamp tissue. During a second period (572), clamp actuator(528) is fully actuated/clamped. As shown by FIG. 12B, during a thirdperiod (574), in which clamp actuator (528) is released to itsbiased/unclamped position, catch trigger (552) interacts with detentfeature (554) to rotate valve (548) and discharge (582) fluid coolant(563) momentarily until catch trigger (552) and detent feature (554)release. This method of blade cooling repeats each time clamp actuator(528) is actuated during operation of instrument (500).

IV. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

A surgical instrument, comprising: (a) a body; (b) a shaft assemblyextending distally from the body and including an acoustic waveguideconfigured to couple with an ultrasonic transducer; (c) an end effector,including: (i) an ultrasonic blade in acoustic communication with theacoustic waveguide, and (ii) a clamp arm movably coupled relative to theultrasonic blade and configured to move from an open position toward aclosed position for compressing a tissue against the ultrasonic blade;(d) a clamp actuator movably coupled relative to the body and configuredto selectively move from a first actuator position toward a secondactuator position, wherein the clamp actuator is operatively coupled tothe clamp arm to thereby direct movement of the clamp arm from the openposition toward the closed position as the clamp actuator respectivelymoves from the first actuator position toward the second actuatorposition; (e) a blade cooling system operatively coupled to the clampactuator and selectively operable to discharge a fluid coolant onto theultrasonic blade while the clamp actuator remains in the first actuatorposition.

Example 2

The surgical instrument of Example 1, wherein the shaft assembly definesa longitudinal axis and further includes a knob operatively connected tothe end effector, wherein the knob is configured to rotate about thelongitudinal axis to thereby rotate the end effector about thelongitudinal axis, and wherein the blade cooling system includes a fluidreservoir within the knob and configured to contain the fluid coolanttherein.

Example 3

The surgical instrument of Example 2, wherein the blade cooling systemfurther includes an access port positioned on the knob and in fluidcommunication with the fluid reservoir for introducing the fluid coolantinto the fluid reservoir.

Example 4

The surgical instrument of any one or more of Examples 2 through 3,wherein the blade cooling system further includes a plunger positionedwithin the fluid reservoir and configured to selectively move thereinfor discharging the fluid coolant from the fluid reservoir.

Example 5

The surgical instrument of any one or more of Examples 2 through 4,wherein the blade cooling system further includes a fluid actuatoroperatively coupled to the plunger and configured to move the plungerfor discharging the fluid coolant from the fluid reservoir.

Example 6

The surgical instrument of Example 5, wherein the fluid actuator islocated on the body.

Example 7

The surgical instrument of any one or more of Examples 5 through 6,wherein the fluid actuator is a slidable push-tab operatively coupled tothe plunger.

Example 8

The surgical instrument of any one or more of Examples 2 through 7, theshaft assembly further including: (i) an inner tube, (ii) an outer tube,and (iii) an interior space between the inner tube and the outer tube,wherein the interior space is in fluid communication with the fluidreservoir and configured to receive the fluid coolant discharged fromthe fluid reservoir for communication toward the ultrasonic blade.

Example 9

The surgical instrument of Example 8, wherein the blade cooling systemfurther includes a fluid passageway fluidly connecting the fluidreservoir to the interior space of the shaft assembly, and wherein theplunger is operable to compress fluid coolant within the fluid reservoirthereby directing the fluid coolant through the fluid passageway.

Example 10

The surgical instrument of Example 9, wherein the blade cooling systemfurther includes a one-way valve positioned within the fluid passageway,wherein the one-way valve is configured to allow the fluid coolant toflow from the fluid reservoir to the interior space, and wherein theone-way valve is configured to inhibit the fluid coolant from flowingfrom the interior space toward the fluid reservoir.

Example 11

The surgical instrument of any one or more of Examples 8 through 11,wherein the blade cooling system further includes a one-way fluid valvepositioned in the interior space between the inner tube and the outertube, wherein the one-way fluid valve is configured to allow the fluidcoolant to distally flow through the interior space toward the endeffector, and wherein the one-way valve is configured to inhibit thefluid coolant from proximally flowing through the interior space awayfrom end effector.

Example 12

The surgical instrument of Example 1, the blade cooling system furtherincluding: (i) a fluid reservoir supported by the body and configured tocontain the fluid coolant, and (ii) a fluid bladder positioned withinthe body, wherein the compressible fluid bladder is operable to receivethe fluid coolant from the fluid reservoir via a first fluid passageway;and wherein the fluid bladder is operable to provide fluid coolant tothe ultrasonic blade via a second fluid passageway.

Example 13

The surgical instrument of Example 12, wherein the clamp actuator isfurther configured to selectively move toward a third actuator position,wherein the clamp actuator is configured to compress the fluid bladderas the clamp actuator is moved toward the third actuator position fordischarging the fluid coolant from the fluid bladder.

Example 14

The surgical instrument of any one or more of Examples 12 through 13,wherein the fluid bladder remains uncompressed in each of the first andthe second actuator positions.

Example 15

The surgical instrument of any one or more of Examples 12 through 14,wherein at least one of the first and the second fluid passagewaysincludes a one-way fluid valve.

Example 16

A surgical instrument, comprising: (a) a shaft assembly, including: (i)an acoustic waveguide configured to couple with an ultrasonictransducer, and (ii) a rotation knob operatively coupled to the shaftassembly, wherein the shaft assembly defines a longitudinal axis and therotation knob is configured to rotate the shaft assembly about thelongitudinal axis; (b) an end effector, including: (i) an ultrasonicblade in acoustic communication with the acoustic waveguide, and (ii) aclamp arm movably coupled relative to the ultrasonic blade andconfigured to move from an open position toward a closed position forcompressing a tissue against the ultrasonic blade; (c) a clamp actuatorconfigured to selectively move from a first actuator position toward asecond actuator position, wherein the clamp actuator is operativelycoupled to the clamp arm to thereby direct movement of the clamp armfrom the open position toward the closed position as the clamp actuatorrespectively moves from the first actuator position toward the secondactuator position; (d) a blade cooling system operably coupled to theclamp actuator and selectively operable to discharge fluid coolant ontothe ultrasonic blade while the clamp actuator is in the first actuatorposition, comprising: (i) a fluid reservoir defined by a cavity withinthe rotation knob, and (ii) a plunger positioned within the fluidreservoir.

Example 17

The surgical instrument of Example 16, further comprising a fluidactuator operatively coupled to the plunger and configured to move theplunger for discharging the fluid coolant from the fluid reservoir.

Example 18

The surgical instrument of any one or more of Examples 16 through 17,the shaft assembly further comprising: (i) an inner tube, (ii) an outertube, and (iii) an interior space between the inner tube and the outertube, wherein the interior space is in fluid communication with thefluid reservoir and configured to receive the fluid coolant dischargedfrom the fluid reservoir for communication toward the ultrasonic blade.

Example 19

A surgical instrument, comprising: (a) a shaft assembly including anacoustic waveguide configured to couple with an ultrasonic transducer;(b) an end effector, including: (i) an ultrasonic blade in acousticcommunication with the acoustic waveguide, and (ii) a clamp arm movablycoupled relative to the ultrasonic blade and configured to move from anopen position toward a closed position for compressing a tissue againstthe ultrasonic blade; (c) a clamp actuator configured to selectivelymove from a first actuator position toward a second actuator position,wherein the clamp actuator is operatively coupled to the clamp arm tothereby direct movement of the clamp arm from the open position towardthe closed position as the clamp actuator respectively moves from thefirst actuator position toward the second actuator position; (d) a bladecooling system operatively coupled to the clamp actuator and selectivelyoperable to discharge a fluid coolant onto the ultrasonic blade whilethe clamp actuator remains in the first actuator position, comprising:(i) a fluid reservoir configured to store fluid coolant; and (ii) acompressible fluid bladder configured to receive fluid coolant from thefluid reservoir via a first fluid passageway, and wherein the fluidbladder is selectively operable to discharge the fluid coolant onto theultrasonic blade via a second fluid passageway.

Example 20

The surgical instrument of Example 19, wherein the clamp actuator isfurther configured to selectively move toward a third actuator position,wherein the clamp actuator is configured to compress the fluid bladderas the clamp actuator is moved toward the third actuator position fordischarging the fluid coolant from the fluid bladder.

V. Miscellaneous

In some exemplary versions, the same vibrational movement that is usedto drive an ultrasonic blade (24, 160) during tissue cutting/sealing maydrive fluid coolant distally along blade (24, 160). As yet anothermerely illustrative example, fluid may be communicated to and/or alongblade (24, 160) in accordance with at least some of the teachings ofU.S. Pat. No. 8,591,459, entitled “Use of Biomarkers and TherapeuticAgents with Surgical Devices,” issued Nov. 26, 2013, the disclosure ofwhich is incorporated by reference herein. It should be understood thatthe teachings in U.S. Pat. No. 8,591,459 relating to dispensation ofmedical fluids may be readily adapted to provide communication ofcooling fluid. It should also be understood that the teachings hereinmay be readily combined with the teachings of U.S. Pat. No. 10,206,705,entitled “Features for Communication of Fluid through Shaft Assembly ofUltrasonic Surgical Instrument,” issued Feb. 19, 2019, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2016/0143659,entitled “Ultrasonic Surgical Instrument with Blade Cooling throughRetraction,” published May 26, 2016, issued as U.S. Pat. No. 10,433,863on Oct. 8, 2019, the disclosure of which is incorporated by referenceherein; and U.S. Pat. No. 10,034,685, entitled “Features to Apply Fluidto an Ultrasonic Blade of a Surgical Instrument,” issued Jul. 31, 2018,the disclosure of which is incorporated by reference herein.

It should be understood that any of the versions of instrumentsdescribed herein may include various other features in addition to or inlieu of those described above. By way of example only, any of theinstruments described herein may also include one or more of the variousfeatures disclosed in any of the various references that areincorporated by reference herein. It should also be understood that theteachings herein may be readily applied to any of the instrumentsdescribed in any of the other references cited herein, such that theteachings herein may be readily combined with the teachings of any ofthe references cited herein in numerous ways. Other types of instrumentsinto which the teachings herein may be incorporated will be apparent tothose of ordinary skill in the art.

It should also be understood that any ranges of values referred toherein should be read to include the upper and lower boundaries of suchranges. For instance, a range expressed as ranging “betweenapproximately 1.0 inches and approximately 1.5 inches” should be read toinclude approximately 1.0 inches and approximately 1.5 inches, inaddition to including the values between those upper and lowerboundaries.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by an operatorimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

We claim:
 1. A surgical instrument, comprising: (a) a body; (b) a shaftassembly extending distally from the body and including an acousticwaveguide configured to couple with an ultrasonic transducer, whereinthe shaft assembly defines a longitudinal axis; (c) an end effector,including: (i) an ultrasonic blade in acoustic communication with theacoustic waveguide, and (ii) a clamp arm movably coupled relative to theultrasonic blade and configured to move from an open position toward aclosed position for compressing a tissue against the ultrasonic blade;(d) a clamp actuator movably coupled relative to the body and configuredto selectively move from a first actuator position toward a secondactuator position, wherein the clamp actuator is operatively coupled tothe clamp arm to thereby direct movement of the clamp arm from the openposition toward the closed position as the clamp actuator respectivelymoves from the first actuator position toward the second actuatorposition; (e) a blade cooling system operatively coupled to the clampactuator and selectively operable to discharge a fluid coolant onto theultrasonic blade while the clamp actuator remains in the first actuatorposition; (f) a knob operatively connected to the end effector, whereinthe knob is configured to rotate about the longitudinal axis to therebyrotate the end effector about the longitudinal axis, and wherein theblade cooling system includes a fluid reservoir within the knob; and (g)a fluid actuator disposed on the body and operable for discharging thefluid coolant from the fluid reservoir, wherein the fluid actuator isconfigured to translate parallel to the longitudinal axis, wherein thefluid actuator is operable to discharge the fluid coolant from the fluidreservoir as the fluid actuator is translated distally along thelongitudinal axis.
 2. The surgical instrument of claim 1, wherein theblade cooling system further includes an access port positioned on theknob and in fluid communication with the fluid reservoir for introducingthe fluid coolant into the fluid reservoir.
 3. The surgical instrumentof claim 1, wherein the blade cooling system further includes a plungerpositioned within the fluid reservoir and operatively coupled with thefluid actuator, wherein the plunger is configured to selectively movetherein for discharging the fluid coolant from the fluid reservoir. 4.The surgical instrument of claim 1, wherein the fluid actuator islocated on an exterior surface of the body.
 5. The surgical instrumentof claim 3, wherein the fluid actuator is a slidable push-taboperatively coupled to the plunger.
 6. The surgical instrument of claim3, the shaft assembly further including: (i) an inner tube, (ii) anouter tube, and (iii) an interior space between the inner tube and theouter tube, wherein the interior space is in fluid communication withthe fluid reservoir and configured to receive the fluid coolantdischarged from the fluid reservoir for communication toward theultrasonic blade.
 7. The surgical instrument of claim 6, wherein theblade cooling system further includes a fluid passageway fluidlyconnecting the fluid reservoir to the interior space of the shaftassembly, and wherein the plunger is operable to compress fluid coolantwithin the fluid reservoir thereby directing the fluid coolant throughthe fluid passageway.
 8. The surgical instrument of claim 7, wherein theblade cooling system further includes a one-way valve positioned withinthe fluid passageway, wherein the one-way valve is configured to allowthe fluid coolant to flow from the fluid reservoir to the interiorspace, and wherein the one-way valve is configured to inhibit the fluidcoolant from flowing from the interior space toward the fluid reservoir.9. The surgical instrument of claim 6, wherein the blade cooling systemfurther includes a one-way fluid valve positioned in the interior spacebetween the inner tube and the outer tube, wherein the one-way fluidvalve is configured to allow the fluid coolant to distally flow throughthe interior space toward the end effector, and wherein the one-wayfluid valve is configured to inhibit the fluid coolant from proximallyflowing through the interior space away from end effector.
 10. Asurgical instrument, comprising: (a) a shaft assembly, including: (i) anacoustic waveguide configured to couple with an ultrasonic transducer,and (ii) a rotation knob operatively coupled to the shaft assembly,wherein the shaft assembly defines a longitudinal axis and the rotationknob is configured to rotate the shaft assembly about the longitudinalaxis, wherein the rotation knob is disposed at a fixed position alongthe longitudinal axis; (b) an end effector, including: (i) an ultrasonicblade in acoustic communication with the acoustic waveguide, and (ii) aclamp arm movably coupled relative to the ultrasonic blade andconfigured to move from an open position toward a closed position forcompressing a tissue against the ultrasonic blade; (c) a clamp actuatorconfigured to selectively move from a first actuator position toward asecond actuator position, wherein the clamp actuator is operativelycoupled to the clamp arm to thereby direct movement of the clamp armfrom the open position toward the closed position as the clamp actuatorrespectively moves from the first actuator position toward the secondactuator position; and (d) a blade cooling system operably coupled tothe clamp actuator and selectively operable to discharge fluid coolantonto the ultrasonic blade, comprising: (i) a fluid reservoir defined bya cavity within the rotation knob, and (ii) a plunger positioned withinthe fluid reservoir, wherein the plunger is configured to longitudinallytranslate relative to the rotation knob.
 11. The surgical instrument ofclaim 10, further comprising a fluid actuator operatively coupled to theplunger and configured to move the plunger for discharging the fluidcoolant from the fluid reservoir.
 12. The surgical instrument of claim11, the shaft assembly further comprising: (i) an inner tube, (ii) anouter tube, and (iii) an interior space between the inner tube and theouter tube, wherein the interior space is in fluid communication withthe fluid reservoir and configured to receive the fluid coolantdischarged from the fluid reservoir for communication toward theultrasonic blade.
 13. The surgical instrument of claim 11, wherein thefluid actuator is configured to translate parallel to the longitudinalaxis.
 14. The surgical instrument of claim 11, wherein the fluidactuator is operable to discharge the fluid coolant from the fluidreservoir as the fluid actuator is translated distally along thelongitudinal axis.
 15. The surgical instrument of claim 11, wherein thefluid actuator is a slidable push-tab operatively coupled to theplunger.
 16. The surgical instrument of claim 12, wherein the bladecooling system further includes a fluid passageway fluidly connectingthe fluid reservoir to the interior space of the shaft assembly, andwherein the plunger is operable to compress fluid coolant within thefluid reservoir thereby directing the fluid coolant through the fluidpassageway.
 17. The surgical instrument of claim 10, wherein the bladecooling system further includes an access port positioned on therotation knob and in fluid communication with the fluid reservoir forintroducing the fluid coolant into the fluid reservoir.
 18. The surgicalinstrument of claim 1, wherein the knob is configured to remain fixed onthe longitudinal axis while fluid coolant is discharged from the fluidreservoir.
 19. The surgical instrument of claim 3, wherein the plungeris configured to translate distally along the longitudinal axis fordischarging the fluid coolant from the fluid reservoir in response tothe fluid actuator translating distally along the longitudinal axis. 20.A surgical instrument, comprising: (a) a body; (b) a shaft assemblyextending distally from the body and including an acoustic waveguideconfigured to couple with an ultrasonic transducer, wherein the shaftassembly defines a longitudinal axis; (c) an end effector, including:(i) an ultrasonic blade in acoustic communication with the acousticwaveguide, and (ii) a clamp arm movably coupled relative to theultrasonic blade and configured to move from an open position toward aclosed position for compressing a tissue against the ultrasonic blade;(d) a blade cooling system selectively operable to discharge a fluidcoolant onto the ultrasonic blade; (e) a knob operatively connected tothe end effector, wherein the knob is configured to rotate about thelongitudinal axis to thereby rotate the end effector about thelongitudinal axis, and wherein the blade cooling system includes a fluidreservoir within the knob, wherein the knob is disposed at a fixedposition along the longitudinal axis; and (f) a plunger positionedwithin the fluid reservoir, wherein the plunger is configured tolongitudinally translate therein relative to the knob for dischargingthe fluid coolant from the fluid reservoir.